Implementing a postcolonial feminist perspective in nursing research related to non‐Western populations In this article, I argue that implementing a postcolonial feminist perspective in nursing research transcends the limitations of modern cultural theories in exploring the health problems of non‐Western populations. Providing nursing care in pluralist countries like Canada remains a challenge for nurses. First, nurses must reflect on their ethnic background and stereotypes that may impinge on the understanding of cultural differences. Second, dominant health ideologies that underpin nurses’ everyday (...) practice and the structural barriers that may constrain the utilization of public healthcare services by non‐Western populations must be further examined. Postcolonial feminism is aimed at addressing health inequities stemming from social discriminative practices. I will draw on extant literature and data of an ongoing ethnography exploring the Haitian caregivers’ ways of caring for ageing relatives at home to unveil how the larger social and cultural world has an impact on caregivers’ everyday lives. Marginalized locations represent privileged sites from which health problems, intersecting with power, race, gender, and social classes, can be addressed. Postcolonial feminism provides the analytic lens to look at the impact of these factors in shaping health experiences. It also suggests redirecting nursing cultural research and practice to achieve social justice in the healthcare system. (shrink)

A patient's experience unfolds through a nurse's personal conversation with herself. Conveyed through three voices, the nurse's dialogue highlights her many internal struggles; those with her conscience on what she understands to be best practice, those important to her as a person, those of an ethical nature that profoundly affect one's search for meaning, and those in the personal–professional realm driven in part by institutional culture. These multivoiced knowledges are confronted in ways that foreground language and understanding as performative acts. (...) At the same time, another journey is co‐constructed with the reader, one that weaves in‐between the symbolic and the real, engaging the imaginary in (inter)play. The nurse's response to the inner conversation with her ‘self/selves’ problematizes practice, illuminates the patient's perspective while highlighting the nurse's sense of her marginal position. Insight into reified and hegemonic assumptions, strategies of how control is maintained through organizational surveillance, trust and moral agency help to foreground personal expectations as the nurse begins to grapple with her own feelings of betrayal. Tackling these insights offers opportunities to rethink oppressive practices in the provision of care. It also enables an alternative appreciation of the everyday dilemmas confronting nurses and offers new meaning to practice. (shrink)

: Feminist standpoint theory remains highly controversial: it is widely advocated, used to guide research and justify its results, and yet is also vigorously denounced. This essay argues that three such sites of controversy reveal the value of engaging with standpoint theory as a way of reflecting on and debating some of the most anxiety-producing issues in contemporary Western intellectual and political life. Engaging with standpoint theory enables a socially relevant philosophy of science.

This essay describes institutional ethnography as a method of inquiry pioneered by Dorothy E. Smith, and introduces a collection of papers which make distinctive contributions to the development of this novel form of investigation. Institutional ethnography is presented as a research strategy which emerges from Smith's wide-ranging explorations of the problematic of the everyday world. Smith's conception of the everyday world as problematic involves a critical departure from the concepts and procedures of more conventional sociologies. She argues for an alternative (...) sociology which begins with the standpoint of the actor in everyday life, rather than from within a professional sociological discourse aligned with the society's ruling institutions. The familiar sociologies of everyday life do not suffice for this purpose, since they deal with local settings and social worlds, but stop short of examining how these are knitted into broader forms of social organization. In contrast, institutional ethnography examines how the scenes of everyday life are shaped by forms of social organization which cannot be fully grasped from within those scenes. The principal tasks of institutional ethnography include describing the coordination of activities in the everyday world, discovering how ideological accounts define those activities in relation to institutional imperatives, and examining the broader social relations in which local sites of activity are embedded. The four papers which follow demonstrate that specific contributions to institutional ethnography can be made in relation to a wide array of topics, methods, and interests. (shrink)

This article reports on a collective effort to position ethics policies within the context of a specific discipline – Applied Language Studies (ALS). Through a discussion of challenges to ALS-specific pedagogical and research practices, this article highlights (1) the need for consistency across institutional Research Ethics Boards in the application of general principles of ethics review, and (2) the recognition of local considerations that are informed by disciplinary approaches not envisioned in current ethics policies. Ethics policies that are driven by (...) substantive ethical intent will recognize pedagogical practices, research methodologies, and epistemological values and traditions that mark a discipline. (shrink)

The article argues that Marx’s use of the concept of ideology in The German Ideology is incidental to a sustained critique of how those he described as the German ideologists think and reason about society and history and that this critique is not simply of an idealist theory that represents society and history as determined by consciousness but of methods of reasoning that treat concepts, even of those of political economy, as determinants. His view of how consciousness is determined historically (...) by our social being does not envisage some kind of mechanical transfer of class status to class consciousness. Rather, he works with an epistemology that takes the concepts foundational to political economy as expressions or reflections of the social relations of a mode of production. The difference between ideology and science is the difference between treating those concepts as the primitives of theory and treating them as sites for exploring the social relations that are expressed in them. Thus, the historical rather than further undermining claims to knowledge, provides both the conditions under which knowledge is possible and its limitations. (shrink)

During the Nazi regime (1933–1945), more than 300 000 psychiatric patients were killed. The well‐calculated killing of chronic mentally ‘ill’ patients was part of a huge biopolitical program of well‐established scientific, eugenic standards of the time. Among the medical personnel implicated in these assassinations were nurses, who carried out this program through their everyday practice. However, newer research raises suspicions that psychiatric patients were being assassinated before and after the Nazi regime, which, I hypothesize, implies that the motives for these (...) killings must be investigated within psychiatric practice itself. An investigation of the impact of the interplay between the notes left by nurses and those by psychiatrists illustrates the active role of the psychiatric medical record in the killing of these patients. Using theoretical insights from Michel Foucault and philosopher Giorgio Agamben and analyzing one part of a particularly rich patient file found in the Langenhorn Psychiatric Asylum in the city of Hamburg, I demonstrate the role of the record in both constructing and deconstructing patient subjectivities. De‐subjectifying patients condemned them to specific zones in the asylum within which they were reduced to their ‘bare life’‐ a precondition for their physical assassination. (shrink)

We argue that critiques of political process theory are beginning to coalesce into new approach to social movements--a "multi-institutional politics" approach. While the political process model assumes that domination is organized by and around one source of power, the alternative perspective views domination as organized around multiple sources of power, each of which is simultaneously material and symbolic. We examine the conceptions of social movements, politics, actors, goals, and strategies supported by each model, demonstrating that the view of society and (...) power underlying the political process model is too narrow to encompass the diversity of contemporary change efforts. Through empirical examples, we demonstrate that the alternative approach provides powerful analytical tools for the analysis of a wide variety of contemporary change efforts. (shrink)

In traditional ethnographies, it is customarily assumed that the field researcher is an outsider who seeks to acquire an insider’s understanding of the social world being investigated. While conducting field research projects on education and tourism in Trinidad (West Indies) we found that the standard distinction between insider and outsider became problematic for us. Our experiences can be understood in terms of two competing conceptions of fieldwork. One, rooted in classical ethnography, views fieldwork as a process whereby the researcher learns (...) to translate the cultural practices of a little-known or misunderstood group into terms understandable to the ethnographic audience. The other, growing out of the institutional ethnography approach pioneered by Dorothy E. Smith, views fieldwork as a process of mapping the relations that govern an institutional complex. In the latter approach, local experiences provide the point of departure for exploring a wider set of social arrangements. In this article, we treat our own fieldwork experiences as points of departure for a reflexive examination of this alternative ethnographic strategy. (shrink)

Gerhard Lenski's classical work on stratification, "Power and Privilege", was an effort to reconcile and to synthesize different approaches to inequality incorporated into the grand theories of the day. It anticipated a variety of developments in the theoretical and empirical understanding of inequalities. These include recognition of the multiplicity of inequalities; emphasis on race, class, gender, and other sources and systems of domination and subordination; and the intersection of these factors in complex patterns to create different standpoints and life consequences. (...) The result was ground-breaking work that underscored the multidimensionality of stratification systems, the variability of their influences, and the notion that their intersection in itself has implications beyond the sum of component parts. In these ways his work foreshadowed the possibilities of finding common ground between modern and postmodern perspectives, to make Lenski the last grand theorist of modernity and a forerunner of postmodern theories of inequality. (shrink)

Feminist standpoint theory remains highly controversial: it is widely advocated, used to guide research and justify its results, and yet is also vigorously denounced. This essay argues that three such sites of controversy reveal the value of engaging with standpoint theory as a way of reflecting on and debating some of the most anxiety-producing issues in contemporary Western intellectual and political life. Engaging with standpoint theory enables a socially relevant philosophy of science.

The aim of this article is to add to the research surrounding nurses' work in hospitals. Throughout history, nurses have faced adverse working conditions, an aspect of their work that remains remarkably unchanged today. Prevailing historical ideologies and sociopolitical conditions influences the context of nurses' work in contemporary hospitals. This research revealed how ruling patriarchal power and nurses' altruistic ways normalize the conditions in hospitals as nurses' work. Moving discourses further add to the work of nurses in hospitals. For example, (...) cost containment strategies, overcapacity and short staffing have resulted in practices to accommodate these problems. While contemporary hospitals may look different, clearly, inside, little has changed since the early days; hospital issues have clearly become an ordinary part of nurses' work. This article discusses how the conditions in hospitals have become an ordinary part of nurses' work. The research in this article emphasizes how prevailing ideologies and institutional discourses make invisible and taken‐for‐granted, how this normalizing of nurses' work contributes to sustaining the hospital's power. (shrink)

RACINE L and PETRUCKA P. Nursing Inquiry 2011; 18: 12–20 Enhancing decolonization and knowledge transfer in nursing research with non-western populations: examining the congruence between primary healthcare and postcolonial feminist approachesThis article is a call for reflection from two distinct programs of research which converge on common interests pertaining to issues of health, social justice, and globalization. One of the authors has developed a research program related to the health and well-being of non-western populations, while the other author has expanded (...) the field of Aboriginal and international research in Canada and abroad. Based on examples drawn from our respective programs of research, we suggest conciliating the philosophy of primary healthcare to postcolonial feminism for decolonizing research and enhancing knowledge transfer with non-western populations. We contend that applying the theoretical and methodological strengths of these two approaches is a means to decolonize nursing research and to avoid western neocolonization. In conciliating primary health care and postcolonial feminism, the goal is to enhance the pragmatic relevance of postcolonial feminism to generate resistance through transformative research for achieving social justice. In tapping into the synergistic and complementary epistemological assumptions of the philosophy of primary health care and postcolonial ‘feminisms’, nurse researchers reinforce the anti-oppresive goals of postcolonial feminist research. Consequently, this approach may enhance both decolonization and knowledge transfer through strategies like photovoice. (shrink)

This paper challenges nurses to join together as a collective in order to facilitate ongoing analysis of the issues that arise for nurses and patients when nursing care is harnessed for health care efficiencies. It is a call for nurses to respond with a collective strategy through which we can ‘talk back’ and ‘act back’ to the powerful rationality of current thinking and practices. The paper uses examples from an institutional ethnographic (IE) research project to demonstrate how dominant approaches to (...) understanding nursing position nurses to overlook how we activate practices of reform that reorganize how we nurse. The paper then describes two classroom strategies taken from my work with students in undergraduate and graduate programs. The teaching strategies I describe rely on the theoretical framework that underpin the development of an IE analysis. Taken into the classroom (or into other venues of nursing activism) the tools of IE can be adapted to inform a pedagogical approach that supports nurses to develop an alternate analysis to what is happening in our work. (shrink)

This essay explores the claim that bioethics has become a mode of biopolitics. It seeks to illuminate one of the myriad of ways that bioethics joins other institutionalized discursive practices in the task of producing, organizing, and managing the bodies—of policing and controlling populations—in order to empower larger institutional agents. The focus of this analysis is the contemporary practice of transnational biomedical research. The analysis is catalyzed by the enormous transformation in the political economy of transnational research that has occurred (...) over the past three decades and the accompanying increase in the numbers of human bodies now subjected to research. This essay uses the work of Michel Foucault, particularly his notion of docile bodies, to analyze these changes. Two loci from the bioethics literature are explored—one treating research in the United States and one treating research in developing countries. In the latter, we see a novel dynamic of the new biopolitics: the ways in which bioethics helps to create docile political bodies that will police themselves and who will, in turn, facilitate the production of docile human bodies for research. (shrink)

Emergency care in large urban hospitals across the country is in the midst of major redesign intended to deliver quality care through improved access, decreased wait times, and maximum efficiency. The central argument in this paper is that the conceptualization of quality including the documentary facts and figures produced to substantiate quality emergency care is socially organized within a powerful ruling discourse that inserts the interests of politics and economics into nurses' work. The Canadian Triage and Acuity Scale figures prominently (...) in the analysis as a high‐level organizer of triage work and knowledge production that underpins the way those who administer the system define, measure and evaluate emergency care processes, and then use this information for restructuring. Managerial targets and thinking not only dominate the way emergency work is understood, determined, and controlled but also subsume the actual work of health‐care providers in spaces called ‘wait times’, where it is systematically rendered ‘unknowable’. The analysis is supported with evidence from an extensive institutional ethnography that shows what nurses actually do to manage the safe passage of patients through their emergency care process starting with the work of triage nurses. (shrink)

This paper examines whether social workers and other direct service practitioners can find utility in ethnomethodology despite or even because of the policy of “indifference”. Garfinkel, the father of ethnomethodology, sets out “ethnomethodological indifference” to insist that EM studies do not supplement, formulate remedies, develop humanistic arguments, or encourage discussions of theory. While at first blush such limits on EM might appear to be a barrier for most social workers this paper argues against first impressions. It is argued that EM (...) provides an important redirection for social work practice and research. Additionally, it is proposed that by approaching EM through Dorothy Smith’s Institutional Ethnography social workers can bridge Garfinkel’s quest for haeccities with extended social relations and actual courses of actions to find congruence between EM and accomplished professional practice. (shrink)

In developing strategies to contest the systematic efforts to dismantle progressive social and economic policies generated through decades of activism, it is important to understand how discursive frames that were significant in social justice organizing in the United States have come to be subjugated, delegitimated, or co-opted, and have lost their power for social justice activism. Using a materialist feminist approach, I first examine the processes of subjugation and explore how movement actors choose frames within bounded discursive fields that become (...) institutionalized, but lose critical feminist or progressive intent. I then discuss the delegitimation of a citizen’s right to government support and the co-optation of progressive movement frames by conservative groups. I conclude with a materialist feminist call to attend to the multiple institutions that contour the discursive field and the everyday practices of social movement organizations. This is a call for collective research, since no single case can attend to all of these dimensions and processes. (shrink)

The concept of the ‘material’ was the focus of much feminist work in the 1970s. It has always been a deeply contested one, even for feminists working within a broadly materialist paradigm of the social. Materialist feminists stretched the concept of the material beyond the narrowly economic in their attempts to develop a social ontology of gender and sexuality.Nonetheless, the quality of the social asserted by an expanded sense of thematerial – its ‘materiality’ – remains ambiguous. New terminologies of materiality (...) and materialization have been developed within post-structuralist feminist thought and the literature on embodiment. The quality of ‘materiality’ is no longer asserted – as inmaterialist feminisms – but is problematized through an implicit deferral of ontology in these more contemporary usages, forcing us to interrogate the limits of both materialist and post-structuralist forms of constructionism. What really matters is how these newer terminologies of ‘materiality’ and ‘materialization’ induce us to develop a fuller social ontology of gender and sexuality; one that weaves together social, cultural, experiential and embodied practices. (shrink)

Consumption is essentially an institutional action. While both the formal institutional environment and cultural embeddedness shape consumption, individuals may reciprocally amend the institutional setting through consumption choices that challenge the prevalent institutional constraints. This paper reconciles theoretical and conceptual premises from institutional and practice theory literature to study the sustainability of consumption. Using institutional ethnography as a methodological approach, the study explores the pendulum between embeddedness and agency in shaping the sustainability of day-to-day consumption of necessary goods; and further, how (...) the external institutional environment may interact with human behaviour to contribute towards sustainability. The study finds a hierarchy of informal institutions, each level of which interacts differently with external changes. For example, sustainability is found to be more widespread the more it is embedded in practices, and this is a result of overall institutional development beyond regulation and choice editing. The results also highlight the importance of understanding unintentional sustainability in consumption practices. (shrink)